Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about stable angina. And you can find written notes on this topic at zero to finals.com

slash stable angina or in the cardiology section of the zero-definals medicine book.

So let's get straight into it.

Angina is caused by atherosclerosis affecting the coronary arteries,

narrowing the lumen of the artery or the inside diameter

and reducing the blood flow to the myocardium,

which is the heart muscle. During times of high demand such as exercise, there's insufficient

supply of blood to meet the demand of the heart. This causes the symptoms of angina, typically of constricting chest pain with or without radiation to the jaw or the arm.

Angina is stable when the symptoms only come on with exertion and they're always relieved by rest or glycerol trinitrate or GTN.

Angina's unstable when the symptoms appear randomly while at rest.

Unstable angina is a type of acute coronary syndrome and it requires immediate management.

Let's talk about the investigations.

All patients with angina should have the following baseline investigations.

A physical examination, including heart sounds, signs of heart failure, blood pressure and

the body mass index, or BMI.

An ECG, although a normal ECG does not exclude stable angina,

a full blood count to look for anemia, us anise, are required before starting an ACE

inhibitor and any other medications, liver function tests are required before starting statins, a lipid profile,

thyroid function tests to check for hypothyroidism or hyperthyroidism, and a HBA1C and fasting

blood glucose to check for diabetes.

In terms of establishing the diagnosis, the options are cardiac stress testing, CT coronary angiography and invasive coronary angiography.

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